Jackie Ta, D.O

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

125067630 Issued in IL

Practice address

1653 W Congress Pkwy
Chicago, IL 60612-3833

Phone

(703) 342-9546

NPI assigned

Jun 20, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Anesthesiology

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Reston Anesthesia Associates PCGroup PAC ID 2567361124, 52 clinicians

Lifebridge Anesthesia Associates LLCGroup PAC ID 2062514888, 109 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sinai Hospital of Baltimore Hospital, Baltimore, MD, CCN 210012
• Reston Hospital Center Hospital, Reston, VA, CCN 490107

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lifebridge Anesthesia Associates, LLC

  • Anesthesiology Physician
  • Randallstown, MD
  • NPI 1003992868
  Medicare reassignment Care Compare group NPD
• Reston Anesthesia Associates, PC

  • Anesthesiology Physician
  • Reston, VA
  • NPI 1932210093

  DC

  Medicare reassignment Care Compare group
• First Colonies Anesthesia Associates, LLC

  • Anesthesiology Physician
  • Columbia, MD
  • NPI 1740218767

  DC

  Medicare reassignment NPD
• Holy Cross Anesthesiology Associate PA

  • Anesthesiology Physician
  • Burtonsville, MD
  • NPI 1376501007

  DC

  Medicare reassignment NPD
• North American Partners in Anesthesia Maryland LLC

  • Anesthesiology Physician
  • Prince Frederick, MD
  • NPI 1093707879
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Reston Hospital Center LLC

  dba Reston Hospital Center

  • General Acute Care Hospital
  • Reston, VA
  • NPI 1053363853
  Care Compare affiliation
• Sinai Hospital of Baltimore, Inc.

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1285672204
  Care Compare affiliation
• Sinai Hospital of Baltimore, Inc.

  dba Grace Medical Center, A Sinai Hospital Facility

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1487325874
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434758400000",
    "number": "1649652165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833",
            "telephone_number": "703-342-9546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833",
            "telephone_number": "703-342-9546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TA",
        "first_name": "JACKIE",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-20",
        "last_updated": "2015-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "125067630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Szyska, D.C.
• T & M Care LLC
• T.J. More, Inc
• T&Z International Inc
• Andrew Ta, MD
• Gina Linda Tabacchi, LCPC
• Courtney Ann Tabaka, D.O.
• Fjona Tabaku, MD, MPH
• Karen CT Tabamo
• Aurore Tabar, OTR/L

• Anesthesiology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Anesthesiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.